The nurses' touch: An irreplaceable component of caring

Beyond Competency: Developing Critical Digital Capabilities in Nursing Students Through Freirean Pedagogy

The digitalisation of healthcare is transforming nursing practice, presenting unique opportunities and challenges that demand more than technical competence from nursing professionals. Despite the growing integration of digital tools, nursing remains in the 'foothills of digital transformation', with significant gaps in the critical and theoretical frameworks required to navigate this shift effectively. This article explores how Paulo Freire's critical pedagogy may address these gaps by fostering critical digital skills in nursing students. Drawing on Freire's concepts of problem-posing education, conscientization, dialogue and praxis, the article proposes a pedagogical model that encourages students to critically examine the socio-political and ethical implications of digital tools within their practice. By aligning Freirean principles with contemporary nursing challenges, the article argues for a shift away from solely competency-based frameworks toward educational approaches that promote reflective, dialogical, and ethically informed engagement with technology. The limitations of Freirean pedagogy, including its difficulty in evidencing direct outcomes, are discussed alongside its potential to cultivate a philosophically engaged nursing workforce capable of navigating the complexities of a digital healthcare environment and its associated impact on the profession. This approach underscores the importance of preserving nursing's core ethical and relational values while embracing the transformative potential of digital technologies.

Development and validation of the nurses' touch comfort evaluation scale in China

BACKGROUND

Touch comfort refers to the level of comfort nurses feel internally when touching patients. Good touch comfort indicates that nurses feel very comfortable during such interactions. With the steady advancement of the "Healthy China" initiative, there is an increasing demand for humanistic care. Good touch comfort is a critical prerequisite for nurses to complete humanistic care measures efficiently. However, there is currently a lack of effective localized measurement tools to evaluate the touch comfort for Chinese nurses. This study aimed to develop a nurses' touch comfort evaluation scale suitable for Chinese nursing culture and to test its psychometric properties.

METHODS

The nurses' touch comfort evaluation scale was developed in three stages. In stage 1, a literature review and team discussions were used to create the initial item pool, followed by two rounds of expert consultations and a pre-survey to refine the items and form the initial scale. In Stage 2, a questionnaire survey was conducted with 231 nurses. Item analysis and exploratory factor analysis (EFA) were employed to optimize the items and explore the scale's structure, resulting in a predictive scale. In Stage 3, the performance of the scale was validated with a sample of 355 nurses, leading to the final version of the scale. Confirmatory factor analysis (CFA) and content validity were used to evaluate the scale's validity, while Cronbach's alpha coefficient, split-half reliability, and test-retest reliability were applied to assess its reliability.

RESULTS

The final scale comprises 4 dimensions (treatment task, physiological comfort, individualized assistance, and emotional support) with 35 items, accounting for 76.661% of the cumulative variance. The scale's Cronbach's alpha coefficient, split-half reliability, and test-retest reliability were 0.981, 0.927, and 0.886, respectively. Confirmatory factor analysis results indicated: standardized chi-square statistics(χ2/df) = 3.432, root mean square error of approximation (RMSEA) = 0.083, comparative fit index(CFI) = 0.911, incremental fit index(IFI) = 0.911, Tacker-Lewis index(TLI) = 0.902, parsimonious comparative fit index (PCFI) = 0.830, parsimony normed fit index(PNFI) = 0.801, combined reliability (CR) values ranged from 0.933 to 0.972, average variance extracted (AVE) values ranged from 0.671 to 0.780, and heterotrait-monotrait ratio (HTMT) values ranged from 0.780 to 0.886, indicating good construct validity. Both scale-level and item-level content validity were 1.

CONCLUSION

The nurses' touch comfort evaluation scale has acceptable reliability and validity, making it an effective tool for assessing the touch comfort of nurses in China.

Supportive Touch in Psychedelic Assisted Therapy

In August 2024, The U.S. Food and Drug Administration rejected Lykos Therapeutics, Inc.'s new drug application for midomafetamine with psychological intervention (MDMA-AT) to treat post-traumatic stress disorder (PTSD). Among the many issues raised during review was concern about a highly publicized case of alleged sexual misconduct by an unlicensed therapist during a Phase 2 study of MDMA and the potential risk of future abuse. This incident of misconduct, along with several other publicized cases of misconduct by guides, facilitators, and shaman offering psychedelic retreats, has raised the question of whether physical contact is ever appropriate during psychedelic-assisted therapy (PAT). Drawing on research about supportive touch in other clinical contexts and taking into consideration features of psychedelics that exacerbate the potential for harm associated with supportive touch, we advocate for a precautionary approach to harm-reduction while arguing that supportive touch ought not be thrown out whole-cloth.

REVIVE Is an Evidence-Based Approach for Nurses to Universally Apply Trauma-Informed Care in Maternity Settings

The principles of trauma-informed care-safety, compassion, collaboration, communication, autonomy, and empowerment-are also the domains most vulnerable to implicit bias and most cited in adverse outcomes in maternal health. Perinatal nurses can practice trauma-informed care universally and thereby foster and advance person-centered care for all individuals with respect to race, ethnicity, religion, or lived experiences. In this article, we present evidence-based nursing interventions, collectively called REVIVE, that are known to promote principles of trauma-informed care. Taken together, the REVIVE interventions may improve health outcomes and reduce disparities in maternal health outcomes because they are proactive nursing interventions independent of implicit bias. REVIVE is described here and intended for use by individual nurses or health care teams to implement and evaluate in different maternity settings.

Advancing Clinical Practice: The Potential of Multimodal Technology in Modern Medicine

Multimodal technology is poised to revolutionize clinical practice by integrating artificial intelligence with traditional diagnostic modalities. This evolution traces its roots from Hippocrates' humoral theory to the use of sophisticated AI-driven platforms that synthesize data across multiple sensory channels. The interplay between historical medical practices and modern technology challenges conventional patient-clinician interactions and redefines diagnostic accuracy. Highlighting applications from neurology to radiology, the potential of multimodal technology emerges, suggesting a future where AI not only supports but enhances human sensory inputs in medical diagnostics. This shift invites the medical community to navigate the ethical, practical, and technological changes reshaping the landscape of clinical medicine.

Reassembling nursing in the digital age: An actor-network theory perspective

This article explores the application of actor-network theory (ANT) to the nursing profession, proposing a novel perspective in understanding nursing in the context of modern digital healthcare. Traditional grand nursing theories, while foundational, often fail to encapsulate the dynamic and complex nature of nursing, particularly in an era of rapid technological advancements and shifting societal dynamics. ANT, with its emphasis on the relationships between human and nonhuman actors, offers a framework to understand nursing beyond traditional paradigms. This article makes two key arguments: first, that nursing can be viewed as a highly organised social assemblage, where both human (nurses, patients and policymakers) and nonhuman actors (technologies, medical equipment, institutional policies) play a crucial role, and second, that ANT can be used to enhance existing nursing theory to better understand the role of technology in nursing practice. The article considers how ANT can provide a more holistic and adaptable model for describing the nursing profession, particularly in an era where technology plays an integral role in healthcare delivery. It discusses the implications of viewing nursing through ANT, highlighting the need for nursing education and practice to adapt to the interconnected and technologically advanced nature of modern healthcare. The article also acknowledges the limitations of ANT, particularly its potential oversimplification of the complex ethical dimensions inherent in nursing and its focus on observable phenomena.

Semi-autonomous touch method merging robot's autonomous touch and user-operated touch for improving user experience in robot touch

The demand for therapeutic robots to alleviate mental health problems is growing. Studies have shown that people's mental health improves when they are touched. Consequently, therapeutic robots are designed to alleviate stress through robot's autonomous touch. However, robot's autonomous touch can sometimes cause discomfort to recipients. This paper proposes a semi-autonomous touch method that merges robot's autonomous touch with user-operated touch to mitigate discomfort while maintaining the sensation of being touched by another person. We conducted an experiment involving 24 participants who were touched on the neck by robots under three conditions: robot's autonomous touch, user-operated touch, and the proposed semi-autonomous touch method condition. Additionally, the study investigated participants' impressions of the robot in each condition. The results showed that semi-autonomous touch condition mitigated discomfort more effectively compared with the robot's autonomous touch method condition. It also enhanced the feeling of being touched by another person entity and suppressed interaction boredom compared with the user-operated touch method condition. Participants reported higher trustworthiness and perceived friendliness in robots utilizing the semi-autonomous touch method compared to those with autonomous touch method condition. These findings indicate that robots featuring the proposed semi-autonomous touch method can provide a comforting experience, leveraging the therapeutic benefits of being touched by another person, and underscore their potential in mental health applications.

The digital dilemma in nursing: a critique of care in the digital age

There is an inherent tension between the nursing profession's empathetic, human-centric ethos and the impersonal nature of digital technology. However, digital solutions such as robot carers could offer convenience, dignity and reduced feelings of burden, so there is potentially a significant misalignment between nursing concepts of care and contemporary patient needs. The notion of 'care' should be reconceptualised to include digital advancements, aligning practice with changing patient expectations and technological progress. A strategy to do this could involve a philosophical overhaul of nursing care models, integration of advanced patient-centric technologies, comprehensive education and training, collaborative development of nursing technologies, showcasing successful digital integration and policy advocacy for digital care models. This transformation is essential if nursing is to stay relevant and effective in the digital era, bridging the traditional care and modern healthcare needs while maintaining its core ethic of care.